Individual provider · Type 1 NPI
Daniel Broussard
Clinical Social Worker · Loma Linda, CA
Practice location
11201 Benton St Rm 1B-126
Loma Linda, CA 92357-9508
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 111281 (CA) |
| Clinical Social Worker Primary | 1041C0700X | 111281 (CA) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1053726554
Daniel Broussard's National Provider Identifier is 1053726554, issued on Jun 24, 2014. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Loma Linda, CA. The record was last updated on Apr 4, 2025.